Insight on a question I do not agree with

Nurses General Nursing

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Recent test had this question on it. I personally do not think that any of the responses are correct. Teacher says option C. What do you think . . . .Please back your response up with references.

A client says, "I drink so much water every day you'd think I would have diarrhea, not constipation!" An appropriate response for the nurse to make to this client is:

A. "You're obviously not drinking enough water!"

B. "You are dehydrated."

C. "Your body only absorbs about 1 liter of water a day."

D. "Are you sure you're drinking as much as you think you are?"

Specializes in Med Surg - Renal.
It has been a long time since I took NCLEX...paper and pencil days......I just can't imagine out right misinformation would purposefully be on there. The question under discussion here, no correct answer has been provided.

Yeah, I think they changed things. They no longer feel it is necessary to provide a correct answer, just one that is the least wrong.

And in the OPs question, C is most definitely the least wrong.

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How about this one from the same class . . . I am starting to get a little worried:

Alcohol consumption recommendations indicate that:

A. Men may consume 20 ounces of red wine daily.

B. Women may have up to 6 ounces of spirits daily.

C. 48 ounces of beer exceeds the daily limit for men.

"right answer" is supposedly A.

Which statement about the use of ACE inhibitors and ARBs is correct?

A. Both stimulate the sympathetic and renin-angiotensin-aldosterone systems

B. ARBs quickly reduce the vasoconstrictive action of angiotension II

C. ACE inhibitors are contraindicated in patient with diabetes

Again "right answer" is A. To my understanding and according to LeMone & Burke Medical-Surgical Nursing these are both incorrect.

Maybe I am not as crazy as some of you think. This was one a test for hypertension.

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"c. "your body only absorbs about 1 liter of water a day."

i would take that to mean that over 1 liter is going to be excreted by the kidneys and will not help with constipation."

you can "take it" any way you want, but that is not what the answer says. it says, "your body only absorbs one liter of water a day." that is so wrong in so many ways it's hard to know where to start on it. i took that as one of those totally bogus answers that looks good if you don't know anything about physiology and might therefore be a good distractor.

if you look at the thread on taking the nclex (i used to teach the review classes and was a nursing instructor for some years), i wrote that one of the ways you discriminate between good and better answers is this: if the stem doesn't call for addressing an immediate safety issue (airway, environmental, etc) then go for the choice that has you seek more information. "tell me more about that," "what do you know about your diet prescription?" and so forth.

this item is, actually, an example of lousy test construction, for all of the distractors (answer choices) are deficient and none are definitively correct. you could respond to the patient in a by saying that increased water intake will not give you diarrhea, and btw, how much water do you take in every day? do you use a liter water bottle by your desk and sip at it often? how often do you fill it up? are you drinking water, or carbonated drinks, iced/sweet tea, coffee; how much? in short, the prudent nurse would realize there isn't enough information here, and get more.

bottom line, though? if those and other questions are truly bogus (like wrong answers you can refute clearly from your pharm. text), the op should compile them and accurate references and write them up, nicely, absolutely deadpan with no snarkiness, and give them to the department head. let him/her take it from there. seriously.

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"C. "Your body only absorbs about 1 liter of water a day."

I would take that to mean that over 1 liter is going to be excreted by the kidneys and will not help with constipation."

Excellent post GrnTea. . . .I think you hit every issue. The idea behind therapuetic communication and the complete lack of phisiological knowledge concerning choice C. I really appreciate your response, and more than anything I have felt vindicated in the fact that the body absorbs way more than 1L of water in a day. Thanks to all the nurses that have years of practicing experience and sound understanding of physiology that have responded.

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"C. "Your body only absorbs about 1 liter of water a day."

I would take that to mean that over 1 liter is going to be excreted by the kidneys and will not help with constipation."

Excellent post GrnTea. . . .I think you hit every issue. The idea behind therapuetic communication and the complete lack of phisiological knowledge concerning choice C. I really appreciate your response, and more than anything I have felt vindicated in the fact that the body absorbs way more than 1L of water in a day. Thanks to all the nurses that have years of practicing experience and sound understanding of physiology that have responded.

It blows my mind that anyone with critical thinking skill would NOT get it....

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It blows my mind that anyone with critical thinking skill would NOT get it....

Lets not get angry here, but it blows my mind that anyone with an ounce of knowledge regarding the physiological process of the body wouldn't be upset by this

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Questions like these are why previously A students can never get more than Bs in nursing classes, doesn't matter if they have reason and logic on their side.

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Thanks everyone for your opinions

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Specializes in Med/Surg, Academics.
How about this one from the same class . . . I am starting to get a little worried:

Alcohol consumption recommendations indicate that:

A. Men may consume 20 ounces of red wine daily.

B. Women may have up to 6 ounces of spirits daily.

C. 48 ounces of beer exceeds the daily limit for men.

"right answer" is supposedly A.

Out of these three, I would have chosen "C."

As for A, that would be 4/5's a bottle of red wine a day. Wow. Really?!

As for B, give me six shots a day, and I would never be sober.

I don't like C at all, but 48 ounces does indeed exceed the daily limit for men...by a lot.

Which statement about the use of ACE inhibitors and ARBs is correct?

A. Both stimulate the sympathetic and renin-angiotensin-aldosterone systems

B. ARBs quickly reduce the vasoconstrictive action of angiotension II

C. ACE inhibitors are contraindicated in patient with diabetes

Again "right answer" is A. To my understanding and according to LeMone & Burke Medical-Surgical Nursing these are both incorrect.

Maybe I am not as crazy as some of you think. This was one a test for hypertension.

I would have chosen B.

I don't like the word "stimulate" in the A answer.

C is definitely wrong.

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Specializes in Med Surg - Renal.
Questions like these are why previously A students can never get more than Bs in nursing classes doesn't matter if they have reason and logic on their side.[/quote']

Yes they can. I did.

The previously A student who stomps her feet, whines, cries, insists her knowledge is superior and picks a wrong answer on purpose because they don't like the word "absorb" gets a B. The previously A student who learns how to beat these stupid questions gets an A.

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Specializes in Med Surg - Renal.
bottom line, though? if those and other questions are truly bogus (like wrong answers you can refute clearly from your pharm. text), the op should compile them and accurate references and write them up, nicely, absolutely deadpan with no snarkiness, and give them to the department head. let him/her take it from there. seriously.

most instructors i've met direct the output of all that work to their circular file.

there are better ways to spend your time than trying to prove you are smarter than your instructors.

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Specializes in Med Surg - Renal.
How about this one from the same class . . . I am starting to get a little worried:

Alcohol consumption recommendations indicate that:

A. Men may consume 20 ounces of red wine daily.

B. Women may have up to 6 ounces of spirits daily.

C. 48 ounces of beer exceeds the daily limit for men.

"right answer" is supposedly A.

Which statement about the use of ACE inhibitors and ARBs is correct?

A. Both stimulate the sympathetic and renin-angiotensin-aldosterone systems

B. ARBs quickly reduce the vasoconstrictive action of angiotension II

C. ACE inhibitors are contraindicated in patient with diabetes

Again "right answer" is A. To my understanding and according to LeMone & Burke Medical-Surgical Nursing these are both incorrect.

Maybe I am not as crazy as some of you think. This was one a test for hypertension.

I don't think you're crazy, and whoever is writing these questions is definitely an idiot.

As far as I know, the recommended ETOH consumption for males is up to two drinks per day. 20 oz of wine is more than that, but it is far closer to the recommendations than B or C. This is definitely a moronic question but A is the best answer.

For the ARB/ACE question, B is correct.

A is wrong because ARB and ACE inhibitors interfere with the RAAS, they do not stimulate it.

C is wrong because there is no such contraindication.

Check again on B, please. If you instructor doesn't budge, you went to the wrong school and I wish you the best of luck!

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